CMS Price Transparency Data

Blood transfusion

Facility: Lafollette Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $536
  • Cash Discount Price: $774
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Lafollette Medical Center is $536. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $774. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.19x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
$774

Average discount available for prompt cash payment at this facility.

Insurance Median
$536

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$450.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $450.73 (100%)
Cash / Self-Pay: $774 (172%)
Insurance Median: $536 (119%)
Cash: $774 (172% of Medicare)
Ins. Median: $536 (119% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $450.73 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $33 - $3,523 7%
Bluecare $33 - $814 7%
Veterans Eval Services $37 8%
Medicaid / KanCare $142 - $5,062 32%
UnitedHealthcare $142 - $20,247 32%
Amerigroup $292 65%
Tricare $391 87%
Node Champva $412 91%
Triwest $420 93%
Humana $422 - $4,454 94%
Medicare (plans) $422 94%
Node Bluecare Plus Tn Mcr Adv $422 94%
Node Hospice Non Par Agree $429 95%
Node Va $429 95%
Node Wellcare Mcr Adv $429 95%
Node Devoted Health Mcr Adv $430 95%
Node Farm Bureau Mcr Adv $430 95%
Aetna $434 - $12,594 96%
Node Blueadvantage Mcr Adv $434 96%
Node Healthspring Mcr Adv $434 96%
Node Amerigroup Mcr Adv $443 98%
Windsor Health Plan $443 98%
Node Nhc Mcr Adv $464 103%
Node Us Dept Of Labor $536 119%
Wellcare $586 - $5,062 130%
Novanet Work Comp Tn $649 144%
Tn Work Comp $656 146%
Self Pay $673 - $5,813 149%
Ambetter / Centene $793 176%
Node Point Comfort Underwriters $943 209%
Cigna $1,535 341%
Multiplan Complementary $1,783 - $15,388 396%
Beech Street Work Comp Tn $66,934 14850%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals